Shanti Das

Plans to recruit nurses from Nepal to help plug shortages in the NHS will expose workers to an “unacceptable risk” of exploitation and should be halted until safeguards are in place, labour experts have warned.

The UK has been accused of pressing ahead with a hiring spree despite concerns about abusive practices by Nepali recruitment agencies, which are notorious for charging illegal fees that leave workers saddled with debt.

The government-to-government deal, signed last month despite Nepal’s status on the World Health Organization’s recruitment “red list”, will begin with an initial pilot involving about 100 recruits but could see thousands of nurses and other healthcare workers move to the UK from Nepal over the next few years.

The Department of Health has hailed the scheme as an “ethical” initiative that will allow for “managed” recruitment to plug UK shortages. A memorandum of understanding says workers should not be charged fees and that recruitment will be overseen by a Nepali government-run “implementation unit”. But critics accuse ministers of turning a blind eye to abusive recruitment practices in Nepal. They say safeguards are needed to protect workers from exploitation.

In May, a study by the Nepal-based research institute Social Science Baha found that about 40% of Nepalis who are interested in foreign employment seek the help of illegal agents. That same month, the Bureau of Investigative Journalism revealed that fruit-pickers from Nepal were routinely charged up to £5,000 in illegal fees for jobs working on UK farms as part of the government’s seasonal worker scheme. Many take out informal loans that they struggle to pay back.  

Evidence gathered by the Observer suggests that agencies operating in Kathmandu have begun offering job-finding services to candidates seeking NHS roles – despite the pledge that no workers will be charged.

Facebook ads targeting Nepali workers, which were live on the platform last week, offered consultancy services, including application support and access to a “sponsor database” for candidates seeking jobs in the UK. A second ad offered “online coaching” for nurses and claimed to offer “the best route to the UK”.

Other ads suggest that recruitment agencies have been targeting nurses in Nepal for months, despite its red list status, which requires that active recruitment should not take place because of the potential effect on the country’s fragile health system. Nepal has 21 nurses per 10,000 people, compared with the UK’s 84 per 10,000.

Andy Hall, an independent migrant rights specialist based in Nepal, said “systemic corruption” meant that “in reality in Nepal there are illegal agents involved in every step of migration”. Many of those charging fees have links with UK-based companies, he said. Hall and other critics, including the UK Nepal Friendship Society, are calling for third-party oversight and the involvement of human rights experts to ensure recruitment does not result in worker exploitation. “For the Department of Health to just say, ‘Everything’s fine,’ is not acceptable,” he said.

In a rare intervention this weekend, the World Health Organization expressed support for practical safeguards, saying they were an “excellent suggestion”.

Jim Campbell, director of health workforce at the WHO, said: “We would very much encourage the UK and Nepal to take on board some of these comments and take all mitigating measures to ensure that there are protections for workers rights, protections from fees and protections from poor working conditions.”

He said having third party oversight or input from human rights organisations would “help the government understand the lived experiences of workers to ensure good practice is being followed”. “It would be a safeguard for the workers in this case,” he said. “You’ve got to ensure that that behaviour is not allowed to start and that if it is, it is identified immediately and eliminated from the bilateral agreement.”

Published on: 25 September 2022 | The Guardian